Organization Active NPI

Comprehensive Cardiology Consultants, Inc

  • Cardiovascular Disease Physician
  • Edgewood, KY
National Provider Identifier
1093905663
Registry record updated Jul 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
COMPREHENSIVE CARDIOLOGY CONSULTANTS, INC
Practice address
1 Medical Village Dr
Heart Failure Clinic
Edgewood, KY 41017-3403
Phone
(513) 861-5555
Fax
(513) 861-0999
NPI assigned
Jul 30, 2007
Last updated
Jul 30, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. George A. Wietmarschen, CEO
Title
Chief Executive Officer
Phone
(513) 872-5700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

1 Medical Village Dr
Heart Failure Clinic
Edgewood, KY 41017-3403

Mailing address

311 Straight St
Suite 301
Cincinnati, OH 45219-1018
Phone (513) 861-5555

Other identifiers 2

IdentifierTypeStateIssuer
0262193MedicaidOH
65940835MedicaidKY

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185753600000",
    "number": "1093905663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 STRAIGHT ST",
            "address_2": "SUITE 301",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452191018",
            "telephone_number": "513-861-5555",
            "fax_number": "513-861-0999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL VILLAGE DR",
            "address_2": "HEART FAILURE CLINIC",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173403",
            "telephone_number": "513-861-5555",
            "fax_number": "513-861-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE CARDIOLOGY CONSULTANTS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-30",
        "last_updated": "2007-07-30",
        "status": "A",
        "authorized_official_last_name": "WIETMARSCHEN",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "513-872-5700",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0262193",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65940835",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.